Focal cartilage lesions
Understanding this condition
Articular cartilage is the thin smooth layer that covers the end of the bones. When a limited, well-defined area of cartilage is damaged — without the generalised involvement seen in osteoarthritis — this is called a focal cartilage lesion.
The cause may be traumatic (sprain, direct blow) or related to a disorder of the underlying bone vascularisation (osteochondritis dissecans). This condition typically affects young, athletic, or active patients.
Symptoms
Localised mechanical pain, sometimes associated with sensations of clicking or brief locking. Intermittent joint effusion is common.
Unlike osteoarthritis, the discomfort is often tied to a specific movement (descending stairs, a particular degree of flexion, running) rather than being diffuse.
How can it progress?
An untreated focal lesion can gradually enlarge, the cartilage fragment may detach (loose body within the joint), and in the long term, early osteoarthritis of the affected compartment may develop.
The earlier the lesion is managed, the better the results. Preservation of joint cartilage is the objective.
Treatment options
For small stable lesions: physiotherapy, activity modification, monitoring. This may be sufficient to stabilise the lesion.
For larger or symptomatic lesions, several arthroscopic surgical techniques can stimulate cartilage repair: microfractures, autologous cartilage grafting (AutoCart), and reattachment of a fragment when possible. A specialist consultation establishes the precise indication.